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Controlled Acts, Public Domain & Authorized Acts

Controlled Acts

The Regulated Health Professions Act, 1991 (RHPA) identifies 14 controlled acts that pose significant risk of harm to the public of Ontario [RHPA section 27(2)]. These acts may only be performed by the regulated health care professionals who are authorized by their profession-specific Acts (e.g., Respiratory Therapy Act (RTA)).

If that authority has not been granted to an individual via their professional specific legislation, there are two alternative processes by which a controlled act can be performed, which are as follows:

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1. Legislative Exceptions & Exemptions

The RHPA identifies certain exceptions where an individual may perform controlled acts even if they do not have the necessary authority to do so, and these are outlined in the Exceptions within the RHPA section of this practice guideline. In addition, there are exemptions in other legislation that enables Respiratory Therapists and other healthcare professions to perform other specific tasks. This is outlined in the Exemptions within the Controlled Acts Regulation section of this practice guideline.
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2. Delegation

Authority to perform a controlled act may be obtained through the process of delegation from a regulated health professional who has the authority to perform the controlled act to another person (regulated or unregulated), who does not have this authority. The controlled acts that are not authorized to Respiratory Therapists but that could be delegated are outlined in the Delegation of Controlled Acts Not Authorized to Respiratory Therapists section of this practice guideline.

Public Domain

If a task is not a controlled act, then it is considered to be in the public domain and may be performed by anyone (regardless of whether they are a regulated healthcare professional or not), provided they are competent to do so. Regulated health professionals must adhere to the standards of practice of their respective profession while performing activities that fall within the public domain.

Examples of Public Domain Tasks…

  1. Administering an oral medication
  2. Spirometry (with no bronchodilators)